Ms O’CONNOR – Minister, I’d like to talk to you about the helipad on the Royal Hobart Hospital roof and the impact that it is having on residents of Hobart. We got right to information data back which shows that between September 2021 and February 2023 – that’s about 16 months, there were a total 1224 landings on the helipad. About a third of them, 34 per cent, or 497, are medical emergency. Can you confirm to the committee that the 727 non-emergency flights cost about $17.5 million?
Mr ROCKLIFF – I will have to seek some information for you on that.
Ms O’CONNOR – Perhaps there is information available which can tell the committee how much these helicopters cost to fly an hour.
Mr ROCKLIFF – Perhaps I better ask Mr Emery to come back to the table and talk about medical retrieval.
Ms O’CONNOR – We’re very interested in the number of non-emergency flights that are coming in over residential areas.
Mr EMERY – Ms O’Connor, obviously, a portion of our ambulance flights by helicopter are non-emergency cases. I don’t have the exact number in terms of the breakdown between emergency and non-emergency flights immediately available. There is a portion of flights that do take place that might not be strictly a life-threatening emergency but they are retrieving a patient from a very remote location across the state that might have significant injuries that require transport to the Royal Hobart Hospital for tertiary care, even if the patient is not in an imminently life-threatening state.
Ms O’CONNOR – Thank you. Our data says that a third of those flights, we have not yet established what the hourly cost is so perhaps that could be answered, 34 per cent of the flights are emergency and medical services flights, and 28 per cent search and rescue flights. Assuming that they are serious enough for a helicopter, that’s fine. There is still about 30 per cent of the flights that come in over residential areas that would appear to be not for essential medical purposes.
Mr EMERY – Ms O’Connor, I would have to look at the detail further but I would say, given the centralised nature of trauma services in the state, particularly as it relates to the Royal Hobart Hospital, patients are retrieved in what we call secondary transfers, where they may be stabilised at the Launceston General or North West Regional Hospital before being flown down to the Royal Hobart Hospital.
There are also a portion of aeromedical incidents that are primary responses. We might have a primary helicopter response to an incident and the patient is immediately flown to the Royal Hobart Hospital based on the severity of their injuries. There are search and rescue missions as well which might initially be an effort to locate a patient but some 50 per cent of those missions subsequently translate into a patient.
Ms O’CONNOR – We have correspondence and feedback from people who live along the flight path. In the original documentation from TasHealth, the K Block helipad, it said, we could expect one or two retrievals a day. Now it is three or four retrievals a day and landings on the helipad. Why has there been such a costly intensification of the use of helicopters at the Royal Hobart Hospital?
Ms Dow – Because all the ambulances are ramped.
Ms O’CONNOR – The ambulances are ramped, yes. I have another question on this.
Mr ROCKLIFF – As I understand it, it is a clinical decision that is made.
Ms O’CONNOR – Is it a clinical decision, though?
Mr EMERY – Ms O’Connor, I would say the total number of aeromedical missions over the last three years, there is 762, this is not unique to Royal Hobart Hospital, sorry, I should say – 762 in 2019-20, 833 in 2020-21, 777 in 2021-22 and 662 through until 31 March 2023. It is predominantly clinical in terms of transfer to tertiary-level care, especially as it relates to secondary aeromedical transfers. But, of course, there are operational circumstances that might dictate the aeromedical transfer of a patient.
Ms O’CONNOR – I am happy to put it on notice. What is the hourly cost of those flights?
And, minister, are you able to explain why the flight path now takes three to four helicopters a day over residential areas in North Hobart, New Town and Glebe? And whether that is a decision that was made because it was easier to do it? Remember, minister, they used to come in down the river and land at the Domain. And now three or four flights a day are flying low over residential areas to land at the helipad. They cannot all be emergency flights.
Mr ROCKLIFF – CASA (Civil Aviation Safety Authority) springs to mind but maybe that is not the correct answer.
Ms O’CONNOR – There is a question about why the flight path now takes all these flights low over residential areas.
Mr ROCKLIFF – We would have to do an analysis to get that information.
Ms O’CONNOR – It’s in an RTI that’s on the public record. If you haven’t analysed it in time for Estimates –
Ms MORGAN-WICKS – In having a look at the data that’s been provided, Ms O’Connor, through the RTI, that has been the case since 2021. I haven’t got the formal analysis to say in terms of increase or not. Certainly, back to 2021 we can see instances where there are four flights or higher a day; but also many days in which there’s one; so it hasn’t just occurred within the 2023 time frame, for example.
Ms O’CONNOR – Thank you, Ms Morgan-Wicks, that’s the data that we have, and, Chair, if I could pursue this for a little bit longer. Do you want me to put on the record the question about the hourly cost of those helicopters? We would also like to know about the total cost of those contracts because, from looking at the data, it looks to us as though – because contracts have been entered into – there’s now a default to using helicopter transport, which is exponentially and significantly more costly than other forms of patient transport for non-emergency transport.
Mr ROCKLIFF – Thank you, Ms O’Connor. Mr Webster?
Mr WEBSTER – The hourly cost for the Bell helicopter, which is the larger helicopter, is $ approximately 4700 per hour. For the smaller BK helicopters – we operate two of those – the cost per hour is approximately $2700,.
Ms O’CONNOR – Thanks for your patience, colleagues at the table. I’m keen to understand this, because we still haven’t got to the bottom of it, why the flight path was changed once the helipad went in so that all the choppers now come in down Campbell Street, low over residential areas, and I don’t believe any noise-testing was undertaken on the impact on residents; perhaps you can disabuse me of this notion?
Mr WEBSTER – The flight path is determined by wind and all of those sorts of things and it was determined by experts. There are very big differences in wind from the high-rise in the middle of the CBD versus the Regatta Ground which was the previous landing site, so we have taken advice on that. There is a study on the noise effects and I am pretty sure that has been provided through RTI to Dr Woodruff in recent times.
To your point about the non-urgent – I take the point that the number of flights is lower this year than it was in 2018-19.
Secondly, there will be some of those non-urgent flights which are returning aircraft from the north or north-west that have been despatched and, for emergency and operational reasons, they will do a transfer back to the south or from the north-west to the north.
Ms O’CONNOR – With respect, and final question: do you think it’s possible we’re getting more flights from the north down here because for 18 months the Department of Health ignored Rotorlift when they said ‘your existing helipad is not useable’. So, there’s a delay there or a lack of capacity at the LGH because your department, Premier, basically did nothing for 18 months and now we’re getting more landings down here at the Royal? That’s true, by the way. I know it’s true.
Mr ROCKLIFF – I beg to differ. Professor Lawler?
Prof LAWLER – There are a couple of things to note as well. There have been increased presentations to emergency departments across the state, and that’s a noted trend across the country.
Ms O’CONNOR – COVID?
Prof LAWLER – Yes, pre-COVID. There will be both pre-COVID and comparing COVID-increased presentations and proportionally there will be an increase in the number of patients who need to be brought down to the Royal. They can be for time-critical situations that can only be managed in the south of the state, such as cardiothoracic or neurosurgical conditions or some complex vascular conditions. It’s also worth noting that one of the initiatives that’s occurred over the last 12 to 18 months is the development and operationalisation of the state Trauma Service which operates out of Hobart, and so patients who have significant trauma are more frequently transferred to the Royal in order to obtain and benefit from that higher level of care.
In addition to Mr Emery’s comments, there are patients who not only are transferred on emergency basis via rotary mode of transport because of the time issues; there are also those who are being supported and transported from rural settings to ensure that they are being escalated to the appropriate level of care.
